Multiple Sclerosis Treatment: What Are the Options?
Navigating the world of multiple sclerosis (MS) can be a daunting task at times. Whether you have been diagnosed for several years or you are newly diagnosed, the ever-changing nature of MS makes living with it a challenge.
From the randomness of relapses or flares to the unpredictable progression, it is enough to drive a person mad. Fortunately for some, some MS treatments make this seemingly insurmountable beast somewhat tameable.
Traditional Multiple Sclerosis Treatment Options
Many multiple sclerosis treatment options exist for MS. There are pills, injections, infusions, and several alternative treatments available. Finding the one that will give you the best results is key.
When I was diagnosed in 2016, my neurologist initially tried Tecfidera, a twice a day pill that helps to keep the troublesome symptoms of MS at bay. Unfortunately, I did not have success with this treatment, so my physician referred me to a doctor that specializes in multiple sclerosis. My MS physician then put me on Ocrevus, an infusion that I receive every six months. While I have had no new lesions with this infusion therapy, I have had no relief of symptoms and have acquired new ones.
There are many different types of multiple sclerosis:
- Relapsing-remitting (RRMS).
- Primary progressive (PPMS).
- Secondary progressive (SPMS).
- Progressive relapsing (PRMS).
Since I have been diagnosed with RRMS, I will focus on the treatments that help this form of MS. The following are some traditional multiple sclerosis treatment options for RRMS:
- Oral therapy is a common choice for those that are not comfortable with needles. They require a regular dosing schedule and are taken either once or twice daily. These include: Tecfidera (dimethyl fumarate), Aubagio (teriflunomide), and Gilenya (fingolimod).
- Self-injectables offer the most options to choose from. You will be trained by a health professional on how to administer this medication. They include: Betaseron (interferon beta-1b), Avonex (interferon beta-1a), Copaxone (glatiramer acetate), Zinbryta (daclizumab), Plegridy (pegylated interferon beta-1a), Rebif (interferon beta-1a), Extavia (interferon beta-1b), and Glatopa (glatiramer acetate).
- Intravenous infusions are injected directly into the vein and are not required as often as self-injectables. These include: Ocrevus (ocrelizumab), Lemtrada (alemtuzumab), Tysabri (natalizumab), and Novantrone (mitoxantrone).
All of these options, as with any medication, come with side effects that may include:
- Flu-like symptoms.
- Redness, pain and/or swelling at the injection site.
- Low white blood cell count.
- Nausea, vomiting, diarrhea.
- Joint pain.
This is not a complete list of possible side effects. Consult the medication’s website or your physician for a more complete list. Many of the medications also require regular blood monitoring.
Natural Therapies for MS
If you want to steer clear of chemical treatments, did you know there are also natural ways to help treat your symptoms of MS? They are far less expensive than traditional treatments and for some, may be more effective.
Though they have medicinal properties, many are not FDA approved or have not yet been researched as a proven method of managing MS symptoms.
- Ashwagandha is an Indian herb also known as the “Queen of Ayurveda.” It has been shown to help with stress, cancer, and neurological diseases. The leaves of the plant helps with memory and other cognitive functions, while the root can help with mobility or movement issues.
- Ginkgo Biloba has been shown to help with fatigue and the other troublesome symptoms of MS just by taking this supplement daily.
- Dandelion root and leaf have antioxidants and anti-inflammatory agents and can also help relieve fatigue, a common symptom of MS.
- Ginger also has strong anti-inflammatory properties, among many other things to help with MS symptoms.
- Turmeric is a natural herb that is commonly used as seasoning. It contains curcuminoids that have been shown to have neuroprotective properties which are important for neurologic diseases like MS.
- Chinese hemp seed is becoming a more popular choice for help in managing MS symptoms. It has a calming effect on the central nervous system and can help with spasticity. Part of the cannabis family, it contains fatty acids that make it a great option for a natural treatment of multiple sclerosis.
- Because vitamin D deficiency has been shown to play a major part in the development of MS, taking this supplement helps eliminate or at least ease many MS symptoms.
- DHA or docosahexaenoic acid is an omega-3 fatty acid that can be found in fish like salmon, tuna and mackerel. It can help with inflammation, neurological function and to protect the central nervous system.
- Magnesium can be found naturally in green leafy vegetables, fish, and nuts or as a supplement in pill form. It is an excellent source to help with myelin damage.
As always, check with your physician before making any changes to your multiple sclerosis treatment plan.
More Alternative Treatments for MS
Complementary and Alternative Medicine (CAM) can be used in conjunction with complementary or conventional treatments.
Before trying these options, the American Academy of Neurologists has a guideline that you should consider, along with your physician’s recommendation. The guideline was designed to help answer these questions:
- Do these therapies reduce symptoms and prevent relapse and disability?
- Can they worsen symptoms or cause serious side effects?
- Can they interfere with disease-modifying therapies (DMTs)?
It is so important to discuss these options and questions with your doctors as many CAMs do not have the backing of research to validate their claims.
Some popular CAMs include diet and exercise, stress management and acupuncture. Look for treatments that have clinical trials to back them up.
Are There Any Other Options?
I read an article recently that mentions intermittent fasting as a successful way to manage your MS symptoms.
One fasting diet limits calories to 500 per day for two to three days a week with the remainder of the week being unrestricted. Many years ago, I would fast for religious reasons, and in my experience, I was able to maintain a healthy weight, and I felt very clean internally. With all the talk of “gut health” in health news recently, it may be worth a try.
According to the National MS Society, a trial using mice has shown that intermittent fasting “enriched gut bacteria and reduced MS-like symptoms.” The study also found that the fasting “changed blood levels of molecules that relate to inflammation” in 16 people with RRMS. Funded by the National MS Society, researchers are now doing a clinical trial to test this fasting theory further.
Changing Your Diet to Manage MS Symptoms
Because some infections thrive in an acidic environment, changing your diet and the way you prepare your food, can greatly reduce inflammation and some MS symptoms. Here are some suggestions to help with your MS diet-changing journey.
- Eat green leafy vegetables. Kale and spinach are excellent choices.
- Eat more raw or steamed vegetables or fruit. Cooking raises the acidity of some foods which makes prime real estate for infection. Tomatoes are an example of a food that becomes more acidic when cooked. Eating them raw is a better choice.
- Reduce red meat intake, especially when your symptoms are worse, or you are experiencing a flare or relapse. Red meat is extremely high in acid, so cutting back or eliminating it can make a big difference in how you feel.
- Reduce your total amount of all meat intake. Meat is an acid causing food, so reducing your meat intake and perhaps considering a vegetarian diet can be helpful in successfully managing your multiple sclerosis symptoms.
- Consider a “green shake” using ground kale as the main ingredient. I use kale quite often. It has incredible nutritional value, and it tastes great in soups and smoothies.
- Add an antioxidant, such as blueberries, to your shake. Plant-based foods like fruits, vegetables (and their juices), whole grains, nuts, seeds, and cocoa are also excellent sources of antioxidants.
- Try juicing or blending as an alternative to getting your daily supply of fruits and vegetables. You tend to lose fiber when you choose to juice as an alternative. If you suffer from bowel issues, try blending rooted fruits and vegetables instead, as it retains fiber.
Can an MS-Specific Diet Help Symptoms?
We know there is no known cure for MS, but there are diets that have worked for some. Because MS is so unique to each person, trial and error become our allies in the search for relief. A few diets to consider in your search are:
- The Swank Diet: Introduced in the 1950s by Dr. Roy Laver Swank, its main idea is to reduce saturated fats. Followers of this diet are encouraged to eat lean fish, vegetables, fruits, whole grains, and non-fat dairy. There are some drawbacks to this diet, as with any you may try, but do your research and find out if it may work for you.
- The Best Bet Diet: This is similar to the Swank Diet in that it is restrictive. Ashton Embry, Ph.D. is the brain behind this diet. He wrote in 1996 about the link between MS and nutrition. The basis of this diet is the avoidance of problem foods like dairy, gluten, legumes, and refined sugar. Eggs and yeast are on the list as well but should be limited and not avoided. It is also recommended to take vitamin and mineral supplements including vitamin D3, calcium, magnesium, and various other vitamins, minerals, oils, and antioxidants.
- The MS Recovery Diet: Created by two female MS sufferers Ann D. Sawyer and Judith E. Bachrach, they have found success by eliminating problem foods as well. They name gluten-containing grains, eggs, legumes, yeast, and sugar just like the Best Bet Diet.
I, personally, am not a fan of fad or “healing” diets. I do believe that there are great health benefits to be found in changing the way we eat.
Before you begin any diet plan, consult with your physician. There are so many important things to consider when choosing or altering a multiple sclerosis treatment plan.
Making Lifestyle Adjustments as a Multiple Sclerosis Treatment
Your MS life can change in a moment. I just experienced this myself today when I discovered that my RRMS is an aggressive form that is resistant to the medications that I have tried so far. I have lost the strength in my legs, and my balance is so off-kilter that I would fail a field sobriety test entirely sober. After this, I decided to change my lifestyle starting with my diet, but also adding other changes.
Here's what you can do to change your MS life:
- Stay active. Exercise is a major component in maintaining a healthy MS life. Before my diagnosis, I was an avid runner. I loved it. I now need to find other ways to stay active. Swimming, yoga, and Tai-Chi are among the many ways to do this. Check your local MS groups or YMCA to find classes. YouTube is also a great place to find yoga exercises specifically designed for MS patients.
- Exercise your brain. If you are like me, your cognitive skills are quickly waning. It is important to keep your brain as active as you keep your body. Word puzzles or games, memory games or reading are excellent ways to keep your brain functioning for as long as possible.
- Sleep well. Proper sleep is important to health and healing. I sometimes have trouble falling asleep and staying asleep all night, so I use melatonin to help with those issues. Having a nighttime routine is also a good habit to have to avoid sleep problems.
- Get help if you suffer from depression. Depression is a common issue when living with MS. Finding a support group or even consulting with your physician about an antidepressant are some options to consider.
- De-stress. Stress is a huge factor when it comes to relapses or worsening of symptoms. Life is stressful, but doing whatever you can to avoid succumbing to it will help you live your best MS life. Surrounding yourself with positive people, meditation and exercise all help to relieve stress. Avoid situations or people that exude negative energy. I joined an online MS group and eventually left it because of the complaining and the absolute negativity on there. I have found that there is something good in every situation. Sometimes it may be difficult to find, but trust me, it’s there.
- Be cool. And not just the hip cool. Keep your body temperature down. Most, if not all of us have experienced the exacerbation of symptoms that come with heat exposure. Cooling vests and doing activities in the cooler part of the day will help tremendously.
The final tip I will give you is to take care of you, and I know that this is more difficult than it sounds.
I used to be superwoman, super-mom, super-whatever-I-put-my-mind-to until multiple sclerosis took my powers. I have a hard time asking for help, but I am learning quickly that I can not do this alone. Also, I have learned that people, especially loved ones, want to help, we have to let them.
Also, if you tend to be forgetful about appointments or plans, use your smartphone. My calendar app has been a lifesaver! Whenever I make an appointment or plans with my girls, I immediately pull up my calendar and add it. It is amazing how quickly I forget things.
Don’t be afraid to depend on apps or people. Our goal is to live our best MS life. To be as happy as we can be with the beast we carry around daily.
Taking breaks is okay. When I am doing an activity, I don’t usually notice my struggle until I am spent that I have overdone it. I pay the price later and generally over the course of several days of recovery.
While we don’t have to let MS take over our lives, we do have to respect its presence there. I hear or read the popular ‘MS-ism’ that “I have MS, but MS doesn’t have me.” Well, sometimes MS does have me, but I don’t have to let it own me.
Multiple sclerosis is an unpredictable, unforgiving disease. It charges into our lives like a bull in a china shop and seems to be on a mission to destroy anything in its path. Our mission, on the other hand, is to do the best we can to minimize the damage.
Changing what we put into our bodies, how we treat ourselves, finding the right disease management therapy, and keeping in constant communication with our MS team will help us live our best MS lives.